@article{Yan2025, 
author = {Sijia Yan and Xi Ming and Jiaying Wu and Xiaojian Zhu and Mi Zhou and Yi Xiao},
title = {Fatal complication unveiled: analyzing intracerebral hemorrhage risk after CAR-T therapy in hematologic malignancies},
year = {2025},
journal = {Brain Hemorrhages},
volume = {6},
number = {5},
pages = {212-219},
keywords = {Intracerebral hemorrhage, Chimeric antigen receptor T cell, Cytokine release syndrome, Coagulopathy, Thrombocytopenia},
url = {https://www.sciopen.com/article/10.1016/j.hest.2025.07.007},
doi = {10.1016/j.hest.2025.07.007},
abstract = {ObjectiveChimeric antigen receptor T (CAR-T) cell therapy has demonstrated significant efficacy in the treatment of hematologic malignancies, yet it can lead to severe complications. Intracranial hemorrhage (ICH), although rare, is a particularly lethal outcome. Current research on the risk factors and underlying mechanisms of ICH post-CAR-T therapy remains limited.MethodsThis retrospective study analyzed 10 cases of ICH among 2255 patients who underwent CAR-T therapy at Tongji Hospital in Wuhan from January 2015 to December 2024. We collected data on baseline characteristics, CAR-T treatment parameters, inflammatory markers, coagulation function, and clinical outcomes.ResultsThe incidence of ICH was 0.44 %, with the median time to onset being 25 days following infusion. All affected patients exhibited thrombocytopenia, and 80 % experienced coagulopathy. Levels of C-reactive protein and Interleukin-6 were significantly elevated before and after treatment. The mortality rate was 90 %, with nine patients succumbing to respiratory and circulatory failure associated with ICH.ConclusionThe development of ICH after CAR-T therapy is strongly linked to thrombocytopenia, coagulopathy, and the inflammatory response triggered by cytokine release syndrome (CRS). Early identification and proactive management of high-risk patients could potentially improve outcomes. Further prospective studies are necessary to confirm risk prediction models and enhance therapeutic strategies.}
}